1. Craniometry and Functional Craniology
Part I:
Anthropometry, Craniometry and Cephalometry
Michael S. Yuan, DDS, MA, PhD
Assistant Professor of Clinical Dentistry
Division of Orthodontics
School of Dental and Oral Surgery
Columbia University
November 25, 2003

2. Lecture outline 1. Introduction: the scope and history
2. Definition and objectives
3. Identification of anatomical landmarks
4. Measurements: metric vs non-metric; direct vs indirect
5. Measuring devices
6. Sex/gender estimation
7. Age estimation
8. Racial/ethnic estimation
9. Other methodology, comparisons, and interpretations
10. Clinical applications

3. Anthropometry • Definition: measurement of human head and body
• Scope: somatometry, osteometry, craniometry, cephalometry, odontometry
• Origin: The methodology probably began because of the interest in the racial classifications (in search of the origin of the human races: monogenism vs polygenism) (Anders Retzius: Swedish; cephalic index)
• Objectives: 1) to examine the differences between species;
2) to investigate the variations within species, which include temporal changes, sexual dimorphism, geographical and ethnic differences;
3) to explore the trends and evolution as well as to interpret fossil records;
4) to apply in clinical diagnosis, treatment planning, forensics, and other commercial applications.

4. Anthropometric Measuring Devices
Direct method
• Sliding caliper
• Hinge (spreading) caliper
• Stadiometer/Osteometric board
• Coordinate caliper
• Head spanner/Todd’s craniostat
• Soft metric tape
• Others
Indirect method
• Digitizer
• Surface scanner
• Other computer assisted imaging and measuring devices (CT scan, MRI, Sonography, etc.)
• Radiography

5. (Non-Vernier vs. Vernier)
Sliding Caliper
(Non-Vernier vs. Vernier)
closed
Vernier calipers: Align the scale to achieve one more digit reading in measurement
open

6. The Mitutoyo Digital Sliding Caliper

7. Spreading Caliper
closed
open

8. Stadiometer “Stretch of the Measuring”
Johann Wolfgang von Goethe, 1779

9. Osteometric Board

10. Todd’s Craniostat (Head Spanner)

11. Soft Metric Tape

12. Body Imaging: 3-D Surface Anthropometry
The Loughborough Anthropometric Shadow Scanner
New Imaging device for soft tissue and surface structures

13. The computerized whole-body image after scanning
(Surface area and volume estimations; Shape capturing and reconstruction)
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14. 3-D Imaging (morphometrics in size and shape)
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Source: Pre-operative (L) and post-operative (R) 3-D images of a trigonocephaly case (2002)

15. Craniometry • Definition: measurement of human dry skull
• Landmarks: 1) true vs relative landmarks
2) mid-sagittal vs bilateral landmarks
• Measurements: 1) qualitative (non-metric) vs
quantitative (metric)
2) metric: angular, arc, linear, volumetric
proportional
• Cranial and facial indices
• Cranial and facial forms

16. The Traditional Landmarks of the Skull
Mid-Sagittal
Acanthion
Alveolare
Alveolon
Apex
ANS (Anterior nasal spine)
Basion
Bregma
Glabella
Gnathion
Incision
Infradentale
Inion
Lambda
Menton
Nasion
Nasospinale
Obelion
Ophryon
Opisthion
Opisthocranion
Orale
Pogonion
PNS (Anterior nasal spine)
Prosthion
Rhinion
Staphylion
Subnasale
Subspinale (A)
Supradentale
Supramentale (B)
Symphysion
Vertex

17. The Traditional Landmarks of the Skull
Bilateral
Alare
Asterion
Coronale
Crotaphion
Dacryon
Ectoconchion
Ectomolare
Endomolare
Euryon
Frontotemporale
Gonion
Jugale
Lacrimale
Mastoidale
Maxillofrontale
Orbitale
Porion
Pterion
Sphenion
Stephanion
Zygion
Zygorbitale

18. Basion: the midpoint of the anterior margin of the foramen magnum.
Bregma: the intersection of the coronal and sagittal sutures in the midline.
Glabella: the most forward projecting point in the midline of the forehead at the level of the supra-orbital ridges and above the nasofrontal suture.
Euryon: the two points on the opposite sides of the skull that form termini of the lines of greatest breadth. The two points are determined instrumentally.
Gnathion: the most anterior and lowest median point on the border of the mandible.
Gonion: the midpoint of the angel of the mandible between body and ramus.
Lambda: the intersection of the sagittal and lambdoidal sutures in the midline.
Mastoidale: the lowest point of the mastoid process
Menton: the lowest median point of the chin.
Nasion: the intersection of the nasofrontal suture with the midsagittal plane. Nasion is the uppermost landmark for the measure of facial height.
Opisthocranion: the most posterior point on the skull not on the external occipital protuberance. It is the posterior end point of maximum cranial length measured from glabella. It is determined instrumentally.
Orbitale: the lowest point in the margin of the orbit; one of the points used in defining Frankfort Horizontal.
Pogonion: the most anterior point in the midline of the chin.
Porion: the uppermost lateral point in the margin of the external auditory meatus. The right and left porion with the left orbitale define the Frankfort Horizontal
Zygion: the most lateral point of the zygomatic arch. It is determined instrumentally.

19. Frankfort Horizontal (FH)
1) A plane passing through three points of the right and left porion and the left orbitale.
2) First proposed at the Craniometric Congress held in Munich, Germany, 1877.
3) An orientation of skull in a consistent and reproducible position.
4) Comparisons: natural head position; horizontal visual axis; and horizontal plane.

20. Skull: Lateral View

21. Skull: Frontal View

22. Skull: Basal View

23. Drawing of a Child at Birth, Age 1, Age 2
Bergmüller (1723), Countway Library, Boston

24. Craniometric Measurements (I)
Cranial circumference
Max. cranial breadth
Min. frontal breadth
Bigonial breadth
Upper facial height
Basion-Prosthion length
Nasal breadth (max.)
Lower nasal breadth
Orbital breadth
Biorbital breadth
Foramen magnum breadth
Cranial height
Max. cranial length
Bizygomatic breadth
Total facial height
Basion-Nasion length
Basal height
Upper nasal breadth
Orbital height
Interorbital breadth
Palate-external breadth & length
Palate-internal breadth & length

25. Craniometric Measurements (II)
Condylo-symphyseal length
Bicondylar width
Min. ramus breadth
Mandibular body height
Symphyseal height
Mastoid length
Ascending ramus height
Mandibular body breadth
Mandibular body length
Total facial angle
Mid-facial angle
Alveolar angle
Nasion-Opisthion arc
Transverse arc
Sagittal cord
Coronal cord

26. Skull: Frontal Measurements

27. Skull: Lateral Measurements

28. Skull: Palatal Measurements

29. Cranial and Facial Indices
Cranial index
Cranial length-height index
Cranial breadth-height index
Total facial index
Upper facial index
Nasal index
Orbital index
External palatal index

30. Orbital Index Chamaeconchy (X-82.99): wide orbits
Orbital height x 100
Orbital Index =
Orbital breadth
Orbital ht.
Orbital br.
Chamaeconchy (X-82.99): wide orbits
Mesoconchy ( ): average or medium
Hypsioconchy (89.00-X): narrow or square orbits

31. Nasal Index Leptorrhiny (X-47.99): narrow nasal aperture
Nasal breadth x 100
Nasal Index =
Nasal height
Leptorrhiny (X-47.99): narrow nasal aperture
Mesorrhiny ( ): average or medium
Platyrrhiny (53.00-X): broad or wide nasal aperture

32. Cranial Index (Dry Skull)
Max. cranial breadth x 100
Cranial Index =
Max. cranial length
Dolichocrany (X-74.99): narrow or long calvarium
Mesocrany ( ): average or medium calvarium
Brachycrany ( ): broad or round calvarium
Hyperbrachycrany (85.00-X): very broad headed calvarium

33. Cephalic Index Dolichocephaly (X-74.99): narrow or long headed
Max. cephalic breadth x 100
Cephalic Index =
Max. cephalic length
Dolichocephaly (X-74.99): narrow or long headed
Mesocephaly ( ): average or medium
Brachycephaly ( ): broad or round headed
Hyperbrachycephaly (85.00-X): very broad headed
Dinaric

34. Facial Index Hypereuryprosopy (X-79.99): very broad face
Total facial height x 100
Facial Index =
Bizygomatic breadth
Hypereuryprosopy (X-79.99): very broad face
Euryprosopy ( ): broad face
Mesoprosopy ( ): average or medium
Leptoprosopy ( ): slender or narrow face
Hyperleptoprosopy (95.00-X): very slender or narrow face
Source: Drs. Bryan Scott & Sonia Abraham

35. Sex/Gender Estimation
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36. Sex/Gender Differences in the Skull
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37. Sexing the Skull (Multiple Regression Analysis) Caucasian samples
1.236 (Glabella.Opisthocranion) – 1.0 (Euryon.Euryon)
(Zygion.Zygion) (Porion.Mastoidale)
= [563.93] (mm)
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Score > : Male
Score < : Female
85.5% confidence of accuracy
Source: modified from Giles (1970)

38. Skull: Infant
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39. Temporal Changes (Infant vs Adult) proportion comparison
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proportion comparison
size comparison

40. Racial/Ethnic Differences
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Caucasoid
Mongoloid
Negroid

41. Differences btw Species: Lateral view Australopithecus afarensis
Female chimpanzee
Female gorilla
Homo erectus
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Homo sapiens sapiens

42. Differences btw Species: Cranial view
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43. Comparison of Skulls: Occipital View
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Modern human
Homo erectus, Archaic Homo sapiens, & Neanderthal

44. The Face
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45. Cephalometry Radiographic Cephalometry 3-D Imaging Growth norms
Growth comparisons
Growth estimation
Growth prediction (?)
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Clinical applications in orthodontics, dento-facial orthopedics, craniofacial surgery

46. Radiographic Cephalogram (PA view)
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47. Cephalometric Radiograph and Tracing (lateral view)
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48. Cephalometric Landmarks
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49. Cephalometric Analysis: Columbia Analysis
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50. Cephalometric Analysis: Finite Element Analysis
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51. References
Bass, W.M. (1987). Human Osteology: A Laboratory and Field Manual (3rd edition). Special Publication No.2 of the Missouri Archeological Society. Columbia, Missouri: Missouri Archeologicall Soceity, Inc..
Krogman, W.M. & Iscan, M.Y. (1986). The Human Skeleton in Forensic Medicine. Springfield, Illinois: Charles C. Thomas Publisher.
Steele, D.G. & Bramblett, C.A. (1998). The Anatomy and Biology of the Human Skeleton. College Station, Texas: Texas A & M University Press
White, T.D. (2000). Human Osteology (2nd edition). San Diego, California: Acadmic Press.

52. Acknowledgments Thanks to Professor Melvin Moss
Professor Letty Moss-Salentijn
Professor Alfonso Solimene
Professor Ralph L. Holloway
And
Dr. Christel Hummert
Dr. Sonia Abraham
Dr. Bryan Scott